Provider Demographics
NPI:1023783784
Name:MICHEL, LATISHA L (CHW, CLC, CPD, MCHS)
Entity type:Individual
Prefix:
First Name:LATISHA
Middle Name:L
Last Name:MICHEL
Suffix:
Gender:F
Credentials:CHW, CLC, CPD, MCHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 W EVANS ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-1174
Mailing Address - Country:US
Mailing Address - Phone:401-662-8846
Mailing Address - Fax:
Practice Address - Street 1:33 W EVANS ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-1174
Practice Address - Country:US
Practice Address - Phone:401-662-8846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No172V00000XOther Service ProvidersCommunity Health Worker
No174N00000XOther Service ProvidersLactation Consultant, Non-RN